Helicobacter Pylori Clinical Trial
Official title:
Fourteen-day Vonoprazan and low-or High-dose Amoxicillin Dual Therapy for Eradicating Helicobacter Pylori Infection: a Prospective, Multi-centers, Open-labeled, Non-inferior, Randomized Clinical Study
Our previous study included 119 Helicobacter pylori(H. pylori)-infected Chinese patients without previous eradication history who were randomized to low-or high-dose amoxicillin-vonoprazan regimens consisting of amoxicillin 1 gram either b.i.d. or t.i.d plus vonoprazan 20 mg b.i.d for 7 or 10 days. Neither 7-or 10-day VA dual therapy with either b.i.d. or t.i.d. amoxicillin achieved satisfied efficacy (i.e., <90%) when given as first-line treatment for H. pylori infection. This study evaluated the efficacy and safety of low-and high-dose amoxicillin-vonoprazan dual therapy for 14 days as first-line treatment for H. pylori in China.
This study was designed as a prospective, open-labeled, randomized non-inferiority clinical study and was conducted in accordance with the Declaration of Helsinki and the guidelines of the Consolidated Standards of Reporting Trials. Consecutive H. pylori-infected subjects ages from 18 to 70 without eradication history were recruited . H. pylori infection was confirmed by immunohistochemistry or urea breath test. The H. pylori-infected subjects were randomly assigned to receive low-or high-dose amoxicillin-vonoprazan dual therapy in a 1:1 allocation ratio, a randomization list was generated using Statistical Product Service Solutions (version 25.0). Low-dose amoxicillin-vonoprazan (L-VA) dual therapy consisted of 1000 mg amoxicillin capsules twice daily and 20 mg vonoprazan Fumarate Tablets twice daily for 14 days. High-dose amoxicillin-vonoprazan (H-VA) dual therapy consisted of 1000mg amoxicillin capsules three times daily and 20mg vonoprazan Fumarate Tablets twice daily for 14 days. Patients and investigators were not blinded to the allocated treatment group. At the start, the detailed demographics and characteristics of the subjects included in this study were recorded, including sex, age, nationality, height, weight, education status, dwelling area, history of smoking and alcohol, concomitant diseases and medication history. In addition, physical examinations and assessment of vital signs were performed. Gastric antrum and body biopsy of the included subjects were obtained during the endoscopy, which were followed by culture and susceptible test of antibiotics. Fecal sample was collected before eradication. During (or after) treatment-emergent adverse events (TEAEs) and concomitant medication were recorded throughout the study, including bloating, nausea, vomiting, abdominal pain, diarrhea, constipation, skin rash, headache, hunger sensation and others. All TEAEs were divided into mild, moderate and severe, TEAEs leading to study drug discontinuation were also recorded. Fecal sample was collected after eradication. The confirmation of H. pylori status was evaluated by 13C-urea breath test 6-8 weeks after treatment. H. pylori status was considered as negative or positive according to the instructions of the manufacturer. Fecal sample was collected at the timepoint of recheck. ;
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